The ongoing case Jhumra v. Orange County Global Medical Center (OCGMC) stems from an alleged delay in care and serves as a stark reminder of the legal obligations for hospitals and medical staffs under the Emergency Medical Treatment & Labor Act (EMTALA).1 EMTALA violations can be devastating for patients, providers, and facilities, so both hospitals and medical staffs should be continuously prepared to meet their EMTALA obligations.
Because EMTALA requires hospitals to respond to emergency medical conditions within their capabilities, hospitals must be cautious not to oversell the services they are capable of providing. Hospitals face legal and regulatory exposure if they misrepresent or overrepresent the scope of the services they are equipped to provide, resulting in delayed treatment when deficiencies are revealed.
Factual Background
According to the complaint filed in Orange County Superior Court (No. 30-2025-01483496-CU-MM-CJC, filed May 16, 2025), the patient presented to the emergency department at OCGMC where it was discovered that he had a ruptured brain aneurysm, putting pressure on and causing a shift in brain structures—a life threatening condition. OCGMC is a Certified Comprehensive Stroke Center with 24/7 emergency care, one of fewer than 300 such facilities throughout the country.2 However, when the patient's aneurysm was discovered, essential equipment to treat the aneurysm was unavailable and no capable neurosurgeons were on call to perform necessary interventions.
As the hours passed, imaging confirmed that the patient's brain bleed was worsening, yet no providers arrived to stabilize his condition. Finally, due to calls made by the patient's wife while witnessing him deteriorate, a surgeon arrived. By the time surgery was performed, the patient had waited over seven hours for treatment and had suffered irreversible injury. The complaint alleges that these delays violated EMTALA and amounted to medical malpractice because OCGMC, and the on-call physicians, failed to stabilize or transfer the patient within their capabilities.
Legal Requirements: A Brief EMTALA Overview
Compliance with EMTALA is not just a regulatory obligation—it is a critical safeguard for patients in crisis and a legal imperative for hospitals and physicians. EMTALA requires hospitals with emergency departments to (1) provide an appropriate medical screening exam to determine whether an emergency medical condition exists, and (2) provide stabilizing treatment for the emergency condition within the hospital's capability, or (3) make an appropriate transfer if the hospital does not have the capacity to stabilize or treat the patient.3 Additionally, hospitals must maintain lists of on-call specialists and ensure they respond in-person within a reasonable amount of time to patients with emergency conditions when requested by the attending emergency department physician.4
EMTALA violations can lead to civil penalties and fines for both facilities and providers.5 Under EMTALA, both the hospital and physicians—including on-call physicians—can be fined for failing to respond or refusing to treat and stabilize patients with emergency medical conditions.6 Violations may also lead to civil actions against facilities for harm to patients.7 Gross and repeated EMTALA violations can lead to Medicare exclusion for individuals and facilities, a veritable professional death sentence.8 Finally, violations can lead to corrective action against physicians under medical staff bylaws, which in turn can lead to mandatory reporting, Medical Board investigations, and licensure action.
In short, EMTALA violations jeopardize patient safety, expose providers and facilities to serious sanctions, and can trigger cascading legal and professional consequences. For this reason, hospitals, physicians, and medical staffs should treat EMTALA as a shared responsibility with real stakes for everyone involved.
Lessons for Hospitals and Medical Staffs
EMTALA does not require hospitals to provide care they aren't equipped for—but it does penalize delays or refusals to treat when care is within the hospital's or medical staff's capabilities. That includes not just equipment and services, but the specialists on call. Hospitals can run into trouble if they overstate the services they can provide, leading to delayed care or exposure when gaps come to light.
To avoid these risks, hospitals and medical staffs should ensure on-call specialists—especially in high-risk specialties—are available as required, consistent with internal policies and federal law. Medical staff bylaws should provide for reliable on-call and back-up coverage that reflects the hospital's actual capacity. EMTALA compliance is a shared responsibility, and policies need to match the realities of facility.
Documentation of compliance is also a critical step. Maintaining accurate on-call schedules and EMTALA compliant-policies, as well as documenting consultations and treatment or transfer decisions, are crucial to EMTALA compliance for facilities and providers. The best way to demonstrate compliance with EMTALA is to document it.
Finally, coordination between medical staff and hospital leadership is essential to reliably and consistently meet EMTALA obligations. Hospital policies, resources, and call schedules must be up-to-date and sufficient. This is an ongoing and collaborative process.
Looking Forward
Jhumra v. OCGMC is still in its early stages and allegations are not fact. But the case offers a cautionary tale: when hospitals and medical staffs are unprepared to meet their EMTALA obligations, patients can suffer and those involved may face serious legal liabilities. EMTALA is not merely a background requirement, it is a frontline standard that facilities and medical staffs must continuously meet. Hospitals and medical staffs should regularly review their EMTALA policies and on-call resources to reduce legal risk and ensure the delivery of safe care.
Footnotes
1. No. 30-2025-01483496-CU-MM-CJC, (Orange Cty. Sup. Ct. May 16, 2025).
2. See Cal. Code Regs., tit. 22, § 100270.203; KPC Health Orange County Global Medical Center, Our Services (last accessed June 5, 2025), https://www.orangecountyglobalmedicalcenter.com/24-hour-emergency-services/.
3. 42 U.S.C. § 1395dd(a)-(c).
4. 42 C.F.R. §§ 489.20(r)(2) and 489.24(j).
5. 42 U.S.C. § 1395dd(d)(1).
6. See 42 CFR Part 1003 Subpart E.
7. 42 U.S.C. § 1395dd(d)(2).
8. Id. at § 1395dd(d)(1)(B).
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